A 68-year-old man presented with a 3-year history of asymptomatic red marks on his limbs. On physical examination, he was found to have numerous circular, erythematous macules with a fine peripheral rim of scale on his upper arms and legs. A clinical diagnosis of disseminated superficial actinic porokeratosis (DSAP) was made. On histopathological examination of the lesional skin on the hands, an angulated parakeratotic tier was seen extending up through the epidermis. The patient was offered a trial of topical imiquimod 5% cream. He was instructed to apply it five ...
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